Client Waivers/Releases ~ Post samples Here

Neon Beach · 01-22-2007, 01:42 PM

neon beach

T A N N I N G
APPLICATION AND WAIVER
-------------------- Please Read Carefully --------------------

Consent to use of the tanning facilities is conditional
upon provision of accurate answers to the following questions and signing of the Waiver of Liability.

Applicants Under The Age Of 16
Will Require A Parent/Guardian To Co-Sign This Waiver.

NAME: ________________________________________ _______ DATE OF BIRTH: ______________________
ADDRESS: _______________________________ CITY: ________________ How did you hear about us? _______________

PHONE: ______________________ EMAIL (optional): ________________________________________ _

PHOTOSENSITIZERS

Please review the following list:
Antimicrobial Agent:

Tetracyclines, espec Demeolocycline, Sulfonamides, espec Sulfanilamide, Griseofulvin, Halogenated salicylanilides.

Other drugs:

Penothiazines, espec Chlorpromazine, Thiazides, PSORALENS, Sulfonylures. Others: Oral Contraceptives, Sunscreens, Tar,

Cosmetics (due to presence of eosin, psoralens, or antimicrobial agents.)

Precautions are necessary for smart tanning. I agree that I will comply with all the instructions on the use of the system and that I am using these services at my own risk, and protecting my vision by using the goggles provided.
We and our employees and agents are not liable for any injury to person or property caused in any way by the use of its services or its premises. Also, they are not liable for the loss or theft of any personal property. Each person is responsible for safeguarding his or her own property.
In consideration of the acceptance of the Application and Waiver, I hereby waive and release for myself and by heirs, executors, and administrators any claims of any nature whatsoever which I might at any time have against the Company or employees and acknowledge that I will use the services provided at my own risk. I confirm that I have given accurate answers to the above questions, that I will carefully follow all directions given and that I am over the age of sixteen (16) years.*
Other things you should know:
1. Your session times are determined according to your skin type, tanning history as well as the condition of OUR tanning lamps and not by the maximum exposure times of the tanning units. We realize that you may have been tanning elsewhere, but we know our equipment the best, please follow our advice. Failure to follow said advice may result in burning for which we can not be held responsible.
2. In order to accurately compile Client histories. We are not able to allow others to use sessions that are on your "screen". Each person wishing to tan must sign a Waiver and be entered into our computer program individually.
3. For your safety and to prevent equipment damage, please follow the instructions regarding the bed acrylics posted in your tanning room.
4. We promote responsible tanning and do not allow double sessions or tanning more than once per day.
5. Please try to be early for your appointments, we may not be able to honour your appointment if you are late. Missing two (2) appointments may result in the loss of one (1) of your sessions.
6. Mineral oil, baby oil, outdoor tanning oils and lotions, etc. are harmful to the tanning bed acrylics. Please do not use any lotion that is not intended for indoor use and/or that has not been approved by one of our Tanning Consultants. Unapproved lotions include Deep Tan, Panama Jack, Banana Boat and Tan2 Max. Using these items may result in the loss of your tanning sessions without notice.
7. Please be cautious when using Hot Action or Tingle lotions. If you are not familiar with what they do try a spot test before purchasing a full bottle. These lotions are not recommended for beginners.
8. To prevent unauthorized use of tanning packages, client photos are taken and will appear only on your client screen.
9. If you ever have any questions, comments or concerns, please let us know!
SIGNATURE: ________________________________________ _____ DATE: _____________________________
* IF APPLICANT IS UNDER SIXTEEN (16) PARENT/GUARDIAN MUST CO-SIGN BELOW:
PARENT/GUARDIAN: ______________________________
You have completed PAGE 1 of 2 Skin Analysis - Next Page

Neon Beach · 01-22-2007, 01:59 PM

SUNLESS

This will Serve as a confirmation that the Spray Tan session has been explained to me.
1. What is the Spray Tan Process?
DHA (Dihydoxyacetone) is used to react with the skins amino acids. The result is like that of the sun.
2. What kind of results can I expect?
You can not force a tan on your skin from the sun., and you shouldn’t try to force a tan on your skin with the spray tan either. Even though there is no skin damage from over exposure when you use the Spray tan. Over exposure can result in a possible orange distortion of the bronze tan way strive to achieve. The Darker you tan naturally the darker you can tan with a spray on tan.
3. How long will my spray tan Last.
3-10 day is the normal range. This depends on your skin type and how well you take care of it. Whys to extend your tan to the long time are. Exfoliate with a none oil expliater before getting sprayed. Keep you skin moisturized after your spray tan, avoid long hot baths or showers, and hot tuns. Salt water can also shorten your spray tan.
4. What are challenges associated with the spray on tan process?
Too much spray can result in an orange tint to the tan. SO we only will spray someone 2 times a week. Following a spray tanning session avoid: Tight clothes, perspiring, leather seats and do not shower for at least 3 hours. Letting your tan stay on overnight is recommended.
5. Are their any side effect?
There may be some people that are allergic to the basic inert ingredients in the spray solution. The worst know reaction in such cases is a person may break out with a acne bump or two. We ask that people who have allergies to look at the ingredients list to ensure that there is no cause of concern before proceeding with the Spray tan process
6. MOST IMPORTANT
When you use the spray tan process you do not experience any protection for the natural sun. Use sunscreen as if you were completely pale and going out into the sun for the first time. ALWAYS avoid over exposure to the natural sun,

Spray on tan Process

Step 1 Exfoliate
Prior to application take a through shower using special exfoliating soap that doesn’t contain ANY oils. Apply NO lotions makeup or deodorant. If you was do so prior to tanning
Step 2 Apparel
In the changing room change into a bathing suit or your underwear. Let us know when you ar ready.
Step 3 Barrier cream
Apply barrier cream to your palms, feet, and finger nails and any extra dry area ie* elbows
Step 4 Application
Now you are ready to be tanned, after you have been tanned allow a few minutes to dry and get dressed. Avoid touching your tan as this will transfer spray tan solution to your fingers.
Step 5 Maintance
In order to retain your bronzed look. You should use a tan extender daily and return with in 10 days for another application
I have been told the risks to the spray on tan and do hold harmless the owners of this salon and their employees.
Signed__________________________________ _________________Date____________

Neon Beach · 01-22-2007, 02:02 PM

xxxxxxxx
T A N N I N G
APPLICATION AND WAIVER
-------------------- Please Read Carefully --------------------

Consent to use of the tanning facilities is conditional
upon provision of accurate answers to the following questions and signing of the Waiver of Liability.

Applicants Under The Age Of 18
Will Require A Parent/Guardian To Co-Sign This Waiver.

NAME: ________________________________________ _______ DATE OF BIRTH: ______________________

ADDRESS: _______________________________ CITY: ________________ How did you hear about us? _______________

PHONE: ______________________ EMAIL (optional): ________________________________________ _

QUESTIONS:
1. Do you tan easily? Yes o No o
2. Do you go regularly into the sun? Yes o No o
3. Do you have a tendency to burn? Yes o No o
4. Do you have any know allergies to sunlight? Yes o No o
5. Have you ever suffered from a major sunburn? Yes o No o
6. Have you ever been advised by a Physician to stay out of the sun? Yes o No o
7. If so, for what reason? ________________________________________ __________________________
8. Are you taking any Medications that would cause sensitivity to sunlight? Yes o No o
Please review the following list:
Antimicrobial Agent: Tetracyclines, espec Demeolocycline, Sulfonamides, espec Sulfanilamide, Griseofulvin, Halogenated salicylanilides.
Other drugs: Penothiazines, espec Chlorpromazine, Thiazides, PSORALENS, Sulfonylures. Others: Oral Contraceptives, Sunscreens, Tar,
Cosmetics (due to presence of eosin, psoralens, or antimicrobial agents.)

Precautions are necessary for safe tanning. I agree that I will comply with all the instructions on the use of the system and that I am using these services at my own risk, and protecting my vision by using the goggles provided.
We and our employees and agents are not liable for any injury to person or property caused in any way by the use of its services or its premises. Also, they are not liable for the loss or theft of any personal property. Each person is responsible for safeguarding his or her own property.
In consideration of the acceptance of the Application and Waiver, I hereby waive and release for myself and by heirs, executors, and administrators any claims of any nature whatsoever which I might at any time have against the Company or employees and acknowledge that I will use the services provided at my own risk. I confirm that I have given accurate answers to the above questions, that I will carefully follow all directions given and that I am over the age of eighteen (18) years.*

Other things you should know:
1. Your session times are determined according to your skin type, tanning history as well as the condition of OUR tanning lamps and not by the maximum exposure times of the tanning units. We realize that you may have been tanning elsewhere, but we know our equipment the best, please follow our advice. Failure to follow said advice may result in burning for which we can not be held responsible.
2. In order to accurately compile Client histories. We are not able to allow others to use sessions that are on your "screen". Each person wishing to tan must sign a Waiver and be entered into our computer program individually.
3. For your safety and to prevent equipment damage, please follow the instructions regarding the bed acrylics posted in your tanning room.
4. We promote responsible tanning and do not allow double sessions or tanning more than once per day.
5. Please try to be early for your appointments, we may not be able to honour your appointment if you are late. Missing two (2) appointments may result in the loss of one (1) of your sessions.
6. Mineral oil, baby oil, outdoor tanning oils and lotions, etc. are harmful to the tanning bed acrylics. Please do not use any lotion that is not intended for indoor use and/or that has not been approved by one of our Tanning Consultants. Unapproved lotions include Deep Tan, Panama Jack, Banana Boat and Tan2 Max. Using these items may result in the loss of your tanning sessions without notice.
7. To prevent unauthorized use of tanning packages, client photos are taken and will appear only on your client screen.
8. If you ever have any questions, comments or concerns, please let us know!

SIGNATURE: ________________________________________ _____ DATE: _____________________________
* IF APPLICANT IS UNDER EIGHTEEN (18) PARENT/GUARDIAN MUST CO-SIGN BELOW:

PARENT/GUARDIAN: ______________________________ You have completed PAGE 1 of 2 Skin Analysis - Next Page
waiver_2002/jpw

Neon Beach · 01-22-2007, 02:03 PM

CLIENT RELESE AND INFORMED CONSENT FORM

WE RESERVE THE RIGHT TO REFUSE SERVICE TO ANYONE AT ANY TIME PLEASE READ THE FOLLOWING INFORMATION AND ACKOWLEDGE THAT YOU UNDER STAND AND ACCEPT ALL PROVISIONS BY SIGNING BELOW

1.We recommend sensible, moderate and responsible exposure to ultraviolet radiation
(UVR).

2.PLEASE FOLLOW ALL INSTRUCTIONS regarding the operation of all tanning equipment. The proper procedure to follow in the tanning room has been clearly explained by the attendant. Please feel free to ask any questions or to voice any concerns that you might have before starting to tan.

IF YOU DO NOT DEVOLP A TAN IN THE SUN, YOU ARE UNLIKELY TO TAN FORM THE USE OF THE TANNING DEVICES AT THIS TANNING SALON
DANGER – ULTRAVIOLET RADIATION

3. AVOIDE OVEREXPOSURE. As with natural sunlight, overexposure can cause eye and skin injury and allergic reactions. Repeated overexposure to UVR may cause photo aging of the skin, dryness, wrinkling and (sometimes fatal) non-melanoma skin cancer. We recommend that you do not tan out doors on days you are tanning indoors, do not tan if you have a sunburn, seek medical care if you suffer a severe, painful and blistering sunburn and that you tan no more often than every other day.

4. WEAR PROTECTIVE EYEWARE. You are required to wear protective eyewear while tanning in our facility. Failure to wear protective eyewear may result in severe burns or long-term injury to the eyes. We recommend that you remove contact lenses before tanning.

I have read the contents of this Client Release and Informed Consent form carefully and state that I am not aware of any medical condition or other reason that would prohibit me from tanning. I understand that I will not be allowed to exceed the maximum allowable time posted on the sun bed. I have been given adequate instructions regarding the proper use of the tanning equipment I will use, understand the risks involved and I do so at my own risk. I hereby agree to release the owners, operators, manufactures, distributors, and any governmental agency from any damages that I might incur due to the use of this tanning facility.

Signature_______________________________ ___________________ Date________________

Witness (Employee signature)______________________________ ___ Date________________

Client #__________________ SPECIAL NEEDS CONSENT_______________________________
This informed consent form has been read to an illiterate or visually handicapped person in my presence.
---------------------------------------------------------------------------------------------------------------------------------
PARENT/GUARDIAN:_______________________________ ___________________________________

I hereby give permission as a parent or guardian of _________________ who is _________ years of age and is

my ____________ to tan at this tanning salon. I have read and understand this Client Release and Informed

Consent Form and agree to accept all of its provisions.

Date: ________ Signed:_________________________________ ____

hockey92 · 01-22-2007, 02:17 PM

Consumer Statement

In Accordance to Rule 15A NCAC 11, Section .1418(a)

DANGER – ULTRAVIOLET RADIATION

Follow instructions.
Avoid overexposure. As with natural sunlight, overexposure can cause eye and skin injury and allergic reactions.

REPEATED EXPOSURE MAY CAUSE PREMATURE AGING OF THE SKIN AND SKIN CANCER.

Wear protective eyewear.

FAILURE TO USE PROTECTIVE EYEWEAR MAY RESULT IN SEVERE BURNS OR LONG-TERM INJURY TO THE EYES.

Medications or cosmetics may increase your sensitivity to the ultraviolet radiation. Consult a physician before using sunlamp or tanning equipment if you are using medications or have a history of skin problems or believe yourself to be especially sensitive to sunlight.

If you do not tan in the sun, you are unlikely to tan from the use of this product.

Consumers should report to the agency any injury for which medical attention was sought or obtained resulting from the use of registered tanning equipment. This report should be made within five working days after the occurrence.

Prior to my initial exposure, I was given the opportunity to read the warning above, it was provided to me by: Gina Newsome of Kool Rayz Tanning.
I believe to the best of my knowledge that the information contained is fully understood.

________________________________________ __________
Signature of Consumer Date:

For individuals UNDER the age of 18, parent or legal guardian must also sign consenting to the above warning and for use of tanning equipment.

_____________________________________ _______________________________
Consumer under the age of 18 Date Parent/Legal Guardian Date
**************************************** ********************************

For illiterate or visually impaired person unable to sign their name.

I _________________________ of ______________________ have read the warning above to ______________________ in the presence of the witness _________________;
and to the best of my knowledge the consumer understands the risks associated with this warning.

_____________________________________ _________________________________
Operator Signature Date Witness Signature Date

RPS Consumer Statement

REV3-12/04

Marca · 01-22-2007, 03:56 PM

Thanks all, very informative!

integritytan · 01-22-2007, 04:07 PM

Hi I am new and was going to ask if anyone has one . Would you mind if I copied this and use this one. It's an added expense for me to have to order this from the distributor. And we are really on a budget thank you in advance.

hockey92 · 01-22-2007, 04:10 PM

copy away.

Neon Beach · 01-22-2007, 04:10 PM

Cash donations accepted.

hockey92 · 01-22-2007, 04:24 PM

I accept credit too

01-22-2007, 01:42 PM	#1 (permalink)
Neon Beach I'm Banned Join Date: Nov 30 2000 Location: Ontario Age: 45 Posts: 52,065 Rep Power: 0	Client Waivers/Releases ~ Post samples Here neon beach T A N N I N G APPLICATION AND WAIVER -------------------- Please Read Carefully -------------------- Consent to use of the tanning facilities is conditional upon provision of accurate answers to the following questions and signing of the Waiver of Liability. Applicants Under The Age Of 16 Will Require A Parent/Guardian To Co-Sign This Waiver. NAME: ________________________________________ _______ DATE OF BIRTH: ______________________ ADDRESS: _______________________________ CITY: ________________ How did you hear about us? _______________ PHONE: ______________________ EMAIL (optional): ________________________________________ _ PHOTOSENSITIZERS Please review the following list: Antimicrobial Agent: Tetracyclines, espec Demeolocycline, Sulfonamides, espec Sulfanilamide, Griseofulvin, Halogenated salicylanilides. Other drugs: Penothiazines, espec Chlorpromazine, Thiazides, PSORALENS, Sulfonylures. Others: Oral Contraceptives, Sunscreens, Tar, Cosmetics (due to presence of eosin, psoralens, or antimicrobial agents.) Precautions are necessary for smart tanning. I agree that I will comply with all the instructions on the use of the system and that I am using these services at my own risk, and protecting my vision by using the goggles provided. We and our employees and agents are not liable for any injury to person or property caused in any way by the use of its services or its premises. Also, they are not liable for the loss or theft of any personal property. Each person is responsible for safeguarding his or her own property. In consideration of the acceptance of the Application and Waiver, I hereby waive and release for myself and by heirs, executors, and administrators any claims of any nature whatsoever which I might at any time have against the Company or employees and acknowledge that I will use the services provided at my own risk. I confirm that I have given accurate answers to the above questions, that I will carefully follow all directions given and that I am over the age of sixteen (16) years.* Other things you should know: 1. Your session times are determined according to your skin type, tanning history as well as the condition of OUR tanning lamps and not by the maximum exposure times of the tanning units. We realize that you may have been tanning elsewhere, but we know our equipment the best, please follow our advice. Failure to follow said advice may result in burning for which we can not be held responsible. 2. In order to accurately compile Client histories. We are not able to allow others to use sessions that are on your "screen". Each person wishing to tan must sign a Waiver and be entered into our computer program individually. 3. For your safety and to prevent equipment damage, please follow the instructions regarding the bed acrylics posted in your tanning room. 4. We promote responsible tanning and do not allow double sessions or tanning more than once per day. 5. Please try to be early for your appointments, we may not be able to honour your appointment if you are late. Missing two (2) appointments may result in the loss of one (1) of your sessions. 6. Mineral oil, baby oil, outdoor tanning oils and lotions, etc. are harmful to the tanning bed acrylics. Please do not use any lotion that is not intended for indoor use and/or that has not been approved by one of our Tanning Consultants. Unapproved lotions include Deep Tan, Panama Jack, Banana Boat and Tan2 Max. Using these items may result in the loss of your tanning sessions without notice. 7. Please be cautious when using Hot Action or Tingle lotions. If you are not familiar with what they do try a spot test before purchasing a full bottle. These lotions are not recommended for beginners. 8. To prevent unauthorized use of tanning packages, client photos are taken and will appear only on your client screen. 9. If you ever have any questions, comments or concerns, please let us know! SIGNATURE: ________________________________________ _____ DATE: _____________________________ * IF APPLICANT IS UNDER SIXTEEN (16) PARENT/GUARDIAN MUST CO-SIGN BELOW: PARENT/GUARDIAN: ______________________________ You have completed PAGE 1 of 2 Skin Analysis - Next Page Last edited by Neon Beach; 02-23-2007 at 01:05 PM.

01-22-2007, 01:59 PM	#2 (permalink)
Neon Beach I'm Banned Join Date: Nov 30 2000 Location: Ontario Age: 45 Posts: 52,065 Rep Power: 0	Re: Client Waivers/Releases ~ Post samples Here SUNLESS This will Serve as a confirmation that the Spray Tan session has been explained to me. 1. What is the Spray Tan Process? DHA (Dihydoxyacetone) is used to react with the skins amino acids. The result is like that of the sun. 2. What kind of results can I expect? You can not force a tan on your skin from the sun., and you shouldn’t try to force a tan on your skin with the spray tan either. Even though there is no skin damage from over exposure when you use the Spray tan. Over exposure can result in a possible orange distortion of the bronze tan way strive to achieve. The Darker you tan naturally the darker you can tan with a spray on tan. 3. How long will my spray tan Last. 3-10 day is the normal range. This depends on your skin type and how well you take care of it. Whys to extend your tan to the long time are. Exfoliate with a none oil expliater before getting sprayed. Keep you skin moisturized after your spray tan, avoid long hot baths or showers, and hot tuns. Salt water can also shorten your spray tan. 4. What are challenges associated with the spray on tan process? Too much spray can result in an orange tint to the tan. SO we only will spray someone 2 times a week. Following a spray tanning session avoid: Tight clothes, perspiring, leather seats and do not shower for at least 3 hours. Letting your tan stay on overnight is recommended. 5. Are their any side effect? There may be some people that are allergic to the basic inert ingredients in the spray solution. The worst know reaction in such cases is a person may break out with a acne bump or two. We ask that people who have allergies to look at the ingredients list to ensure that there is no cause of concern before proceeding with the Spray tan process 6. MOST IMPORTANT When you use the spray tan process you do not experience any protection for the natural sun. Use sunscreen as if you were completely pale and going out into the sun for the first time. ALWAYS avoid over exposure to the natural sun, Spray on tan Process Step 1 Exfoliate Prior to application take a through shower using special exfoliating soap that doesn’t contain ANY oils. Apply NO lotions makeup or deodorant. If you was do so prior to tanning Step 2 Apparel In the changing room change into a bathing suit or your underwear. Let us know when you ar ready. Step 3 Barrier cream Apply barrier cream to your palms, feet, and finger nails and any extra dry area ie* elbows Step 4 Application Now you are ready to be tanned, after you have been tanned allow a few minutes to dry and get dressed. Avoid touching your tan as this will transfer spray tan solution to your fingers. Step 5 Maintance In order to retain your bronzed look. You should use a tan extender daily and return with in 10 days for another application I have been told the risks to the spray on tan and do hold harmless the owners of this salon and their employees. Signed__________________________________ _________________Date____________

01-22-2007, 02:03 PM	#4 (permalink)
Neon Beach I'm Banned Join Date: Nov 30 2000 Location: Ontario Age: 45 Posts: 52,065 Rep Power: 0	Re: Client Waivers/Releases ~ Post samples Here CLIENT RELESE AND INFORMED CONSENT FORM WE RESERVE THE RIGHT TO REFUSE SERVICE TO ANYONE AT ANY TIME PLEASE READ THE FOLLOWING INFORMATION AND ACKOWLEDGE THAT YOU UNDER STAND AND ACCEPT ALL PROVISIONS BY SIGNING BELOW 1.We recommend sensible, moderate and responsible exposure to ultraviolet radiation (UVR). 2.PLEASE FOLLOW ALL INSTRUCTIONS regarding the operation of all tanning equipment. The proper procedure to follow in the tanning room has been clearly explained by the attendant. Please feel free to ask any questions or to voice any concerns that you might have before starting to tan. IF YOU DO NOT DEVOLP A TAN IN THE SUN, YOU ARE UNLIKELY TO TAN FORM THE USE OF THE TANNING DEVICES AT THIS TANNING SALON DANGER – ULTRAVIOLET RADIATION 3. AVOIDE OVEREXPOSURE. As with natural sunlight, overexposure can cause eye and skin injury and allergic reactions. Repeated overexposure to UVR may cause photo aging of the skin, dryness, wrinkling and (sometimes fatal) non-melanoma skin cancer. We recommend that you do not tan out doors on days you are tanning indoors, do not tan if you have a sunburn, seek medical care if you suffer a severe, painful and blistering sunburn and that you tan no more often than every other day. 4. WEAR PROTECTIVE EYEWARE. You are required to wear protective eyewear while tanning in our facility. Failure to wear protective eyewear may result in severe burns or long-term injury to the eyes. We recommend that you remove contact lenses before tanning. I have read the contents of this Client Release and Informed Consent form carefully and state that I am not aware of any medical condition or other reason that would prohibit me from tanning. I understand that I will not be allowed to exceed the maximum allowable time posted on the sun bed. I have been given adequate instructions regarding the proper use of the tanning equipment I will use, understand the risks involved and I do so at my own risk. I hereby agree to release the owners, operators, manufactures, distributors, and any governmental agency from any damages that I might incur due to the use of this tanning facility. Signature_______________________________ ___________________ Date________________ Witness (Employee signature)______________________________ ___ Date________________ Client #__________________ SPECIAL NEEDS CONSENT_______________________________ This informed consent form has been read to an illiterate or visually handicapped person in my presence. --------------------------------------------------------------------------------------------------------------------------------- PARENT/GUARDIAN:_______________________________ ___________________________________ I hereby give permission as a parent or guardian of _________________ who is _________ years of age and is my ____________ to tan at this tanning salon. I have read and understand this Client Release and Informed Consent Form and agree to accept all of its provisions. Date: ________ Signed:_________________________________ ____

01-22-2007, 02:17 PM	#5 (permalink)
hockey92 Looking at my Ta-Tas ..eh Join Date: Aug 31 2004 Location: North Carolina Posts: 3,161 Rep Power: 10	Re: Client Waivers/Releases ~ Post samples Here Consumer Statement In Accordance to Rule 15A NCAC 11, Section .1418(a) DANGER – ULTRAVIOLET RADIATION Follow instructions. Avoid overexposure. As with natural sunlight, overexposure can cause eye and skin injury and allergic reactions. REPEATED EXPOSURE MAY CAUSE PREMATURE AGING OF THE SKIN AND SKIN CANCER. Wear protective eyewear. FAILURE TO USE PROTECTIVE EYEWEAR MAY RESULT IN SEVERE BURNS OR LONG-TERM INJURY TO THE EYES. Medications or cosmetics may increase your sensitivity to the ultraviolet radiation. Consult a physician before using sunlamp or tanning equipment if you are using medications or have a history of skin problems or believe yourself to be especially sensitive to sunlight. If you do not tan in the sun, you are unlikely to tan from the use of this product. Consumers should report to the agency any injury for which medical attention was sought or obtained resulting from the use of registered tanning equipment. This report should be made within five working days after the occurrence. Prior to my initial exposure, I was given the opportunity to read the warning above, it was provided to me by: *Gina Newsome* of *Kool Rayz Tanning.* I believe to the best of my knowledge that the information contained is fully understood. ________________________________________ __________ Signature of Consumer Date: For individuals UNDER the age of 18, parent or legal guardian must also sign consenting to the above warning and for use of tanning equipment. _____________________________________ _______________________________ Consumer under the age of 18 Date Parent/Legal Guardian Date ************************************** ****************************** For illiterate or visually impaired person unable to sign their name. I _________________________ of ______________________ have read the warning above to ______________________ in the presence of the witness _________________; and to the best of my knowledge the consumer understands the risks associated with this warning. _____________________________________ _________________________________ Operator Signature Date Witness Signature Date RPS Consumer Statement REV3-12/04 __________________ www.koolrayztanning.com www.mymonavie.com/ginanewsome

01-22-2007, 03:56 PM	#6 (permalink)
Marca I'm Banned Join Date: Mar 17 2006 Location: The Netherlands Posts: 7,065 Rep Power: 0	Re: Client Waivers/Releases ~ Post samples Here Thanks all, very informative!

01-22-2007, 04:07 PM	#7 (permalink)
integritytan Join Date: Jan 22 2007 Location: Carney Posts: 13 Rep Power: 0	Re: Client Waivers/Releases ~ Post samples Here Hi I am new and was going to ask if anyone has one . Would you mind if I copied this and use this one. It's an added expense for me to have to order this from the distributor. And we are really on a budget thank you in advance.

01-22-2007, 04:10 PM	#8 (permalink)
hockey92 Looking at my Ta-Tas ..eh Join Date: Aug 31 2004 Location: North Carolina Posts: 3,161 Rep Power: 10	Re: Client Waivers/Releases ~ Post samples Here copy away. __________________ www.koolrayztanning.com www.mymonavie.com/ginanewsome

01-22-2007, 04:10 PM	#9 (permalink)
Neon Beach I'm Banned Join Date: Nov 30 2000 Location: Ontario Age: 45 Posts: 52,065 Rep Power: 0	Re: Client Waivers/Releases ~ Post samples Here Cash donations accepted.

01-22-2007, 04:24 PM	#10 (permalink)
hockey92 Looking at my Ta-Tas ..eh Join Date: Aug 31 2004 Location: North Carolina Posts: 3,161 Rep Power: 10	Re: Client Waivers/Releases ~ Post samples Here I accept credit too __________________ www.koolrayztanning.com www.mymonavie.com/ginanewsome

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